Dr. Danielle DeLuca-Pytell on protecting your skin during chemotherapy

Chemotherapy can wreak havoc on the skin. Chemotherapy kills off cancer cells but often it hits healthy cells, too, especially those of the skin, which can cause discoloration, irritation, burning, acne, skin rashes and dryness. During The Breast of Everything podcast, Danielle DeLuca-Pytell, MD, plastic surgeon, talks with Linsey Gold, DO, breast surgeon with Comprehensive Breast Care, about what cancer patients can do to protect their skin from the side effects of chemotherapy and rebuild the skin barriers broken down as a result of treatments. Dr. DeLuca-Pytell recommends CPMS: cleanse, protect, moisturize and soothe. A patient’s skin regimen should start about a week before treatment begins and continue during and after chemotherapy. 

Transcript

Unknown Speaker  0:01  
Welcome to the breast of everything podcast your trusted resource for breast health information support and encouragement. Your host today is Dr. Lindsay gold of comprehensive breast care. Welcome. Welcome to the breast of everything podcast. I'm Dr. Lindsay gold of comprehensive breast care. Our guest today is Dr. Danielle DeLuca Patel, better known as your girlfriend, the plastic surgeon, Dr. DeLuca Patel is a board certified plastic surgeon whose own medical experience nudged her to change career paths from the arts to medicine. After graduating from Tufts University in completing a post bachelor degree at Bryn Mawr College, she attended Michigan State University College of human medicine. She completed her residency in Plastic and Reconstructive Surgery at the University of Texas Medical branch at Galveston and a cosmetic surgery fellowship at the Institute of aesthetic surgery and medicine in Mount Kisco, New York. As a patient herself, she knows how it feels to be on the other side of the Examination Table. Combining art and science with compassion and understanding. She offers patients a life changing opportunity for improvement, both externally and internally. Today, she will talk about your girlfriend's guide to skincare and chemotherapy. And we are going to have a good time. Welcome Dr. DeLuca. Vitale, thank you so much for joining us. Thank you, Dr. Gold, it is a pleasure to be on your podcast. So to all our listeners, thank you for joining and Dr. DeLuca. Vitale, we like to call her DDP at the hospital, because her first name is Danielle. So sometimes we refer to each other by first names, which is okay, because we are friends. So, um, let's talk I just want to say how did you come up with the phrase, your girlfriend, the plastic surgeon? Well, it's interesting, I found that whenever I would go someplace outside of my office, and I was in a group of people that maybe I was meeting for the first time when it came up that I was a plastic surgeon. Everybody wanted to ask me questions, Botox, or bellies or,

Unknown Speaker  2:21  
or breasts, and I would chat with them. And when I was in my office, things felt a lot more formal. And I thought, it's easy to talk when we're outside of the office. And people can kind of confide in you like you're a girlfriend. And since I am a girl, and I am an I'm somebody's friend, I figured it would kind of be nice to be able to get that more casual atmosphere into my office. So if you come into my office, you go right onto a couch, and we have a talk. And then you go into an exam room when we do an exam. So it came out of that hole going to cocktail parties and having a glass of wine and talking about Botox. So you just come here to my office, we do the same thing with no wine. Yes. So I think I was telling you the story the other day, but I'll tell the listeners, we I had a lovely young patient in my office. So her mom was about my age. And of course we have masks on and you can't always see everybody but I you know, everybody's vaccinated. She's like, I pulled my mask down. She's like, Oh, my God, you know, I thought you were in your 30s. Well, full disclosure, I'll be 47 in July, and I'm like, Oh my god, that is great. I can't wait. I can't wait to tell my girlfriend. She's a plastic surgeon. And then I thought, oh, maybe that's how she got the name. But yes, so for the listeners. I mean, you can't see my lovely face, but it is textured. Yes, thank you, Dr. DeLuca. By tell I am her patient as well for skincare. So, so let's talk about that because I love it and fortunately not going through chemotherapy, but that really wreak some havoc on your skin. And of course, we get a lot of questions about it, and I don't have any good answers. So what exactly happens to a woman scan during chemotherapy that makes this such a challenge? Well, as you know, chemotherapy is a treatment to

Unknown Speaker  4:28  
kill off cancer cells. But a lot of the treatments are not able to be completely focused just on the cancer at hand. Sometimes it targets the good cells in our body too. So when chemo happens, there can be a lot of side effects to the skin so people can complain of rashes that either are itchy or perhaps not itchy, changes in the pigment of their face. They may get more spots and dark patches on their face. They can also

Unknown Speaker  5:00  
Have a lot of sensitivity to the sun. Other people will complain of redness, thicker skin dryness, pain, that's like having a sunburn without having a sunburn. A lot of women have dry lips, sallow skin, their face me flush or be plagued again by acne. And the reason is that the reason that you see these changes is because the skin barrier gets compromised during chemotherapy. So we have to make sure that part of skincare during chemotherapy helps to bring the skin back to its sort of basic form, which is providing a barrier to all the stuff that's inside our bodies. Yes, and I do hear a lot of those complaints as I see people through their treatment, lots and lots of them. So is there a way to sort of divide this into what do we do to prepare our skin for chemo? Then? What do we do with it during chemo? And then maybe post? Or is it just all the same thing? How, how will How should we look at this? Well, as as I was driving over here, I thought of a way to make the sort of regimen memorable. So I think that preparing the skin for chemotherapy and also treating the skin during chemotherapy are very similar. So I've come up with a little expression. So everybody knows PMS, because we're all women. So during chemotherapy skincare, you need to think of cpms. So that stands for cleanse, protect, moisturize and soothe. And it's not necessarily in that order. But basically, before you start chemotherapy, you should have optimized your skincare. So your skin is is hydrated and moisturized, you're basically starting with a full tank of gas in your skin, that includes being well hydrated. So drinking water is really important. Making sure that your skin is is well cleanse that you have gentle products that you have been using, and that you continue to use throughout your treatment, so that you're not taken by surprise.

Unknown Speaker  7:26  
The first part of the cpms is the cleanse part. All of the products that you're looking for when you are about to have chemotherapy, or you're going through chemotherapy should be very gentle. They shouldn't have any dyes or colors, any fragrance, or any detergents in them. And that is to again, make sure that you're protecting the skin which can become very sensitive during chemotherapy.

Unknown Speaker  8:01  
You don't well I do carry products in my office that are safe for use during chemotherapy. You can also find them at your drugstore, likely in the baby aisle, so anything that's good for baby's skin is going to be similarly good for chemotherapy skin.

Unknown Speaker  8:16  
moisturizing is really important because there the chemotherapy can affect the sweat glands so your skin which normally produces oil will produce less of it. So the

Unknown Speaker  8:32  
moisture has to be replenished. So a gentle moisturizer is important to us again, without any anything fragrance, something that feels good on your on your skin. And other things that are important are to avoid things that you may have used previously that can become irritating, like

Unknown Speaker  8:54  
exfoliating scrubs are things that are alcohol based. Even things that are that are natural, like a menthol or Eucalyptus can cause a lot of burning of the skin.

Unknown Speaker  9:08  
So again, things that help to calm, calm the skin, and sometimes there's a little bit of trial and error. So if something doesn't feel good on if it burns or tingles and you need to put that aside.

Unknown Speaker  9:25  
Yep, that's great. The S i forgot what the S stands for Su. Oh, sing Yes. Yes. So you might have acne from the use of steroids or maybe you have sun sensitivity. You want to soothe those irritants. So for someone who develops acne during chemotherapy as perhaps a response to steroids, we're going to have those people avoid using retinoids which are very powerful skincare ingredients.

Unknown Speaker  10:00  
But that might not be the best idea. During chemotherapy, something like salicylic acid would be probably a better choice because even though it is an acid, it is a relatively gentle one that your skin can tolerate. Things like toners and astringents are going to strip the skin of their natural protective oils, and also likely be very irritating. So those also need to be avoided. Yeah, for someone who has irritated skin, like flicky, sunburn, any uncomfortable skin, those folks are going to want to use products that have antioxidants in them, vitamin C, green tea,

Unknown Speaker  10:47  
water based products that are going to moisturize and also soothe the skin. And it's a process of cleanse, then moisturize and moisturize until your skin no longer feels tight.

Unknown Speaker  11:04  
And then depending on what particular issue may be going on, then adding in a product, perhaps for discoloration or for acne are for some very flaky skin. So it's not a bad idea for someone going through chemotherapy, if they do have these skincare concerns to consult with either a dermatologist or an aesthetician we carry a line of products that are safe for use. And again, sometimes this you know there's a lot of, there's an awful lot of stuff that goes on when people are going through chemotherapy. So it's not a one size fits all program. But this is one of the many things that the women should be aware of and should ask for help when they need it. So I was gonna ask, you know, women don't feel good. They often feel ugly during chemotherapy. What if they come in and want various cosmetic type treatments? Would you recommend that during chemotherapy? So that's an awesome question. I'm going to reference that there is a study that was done in the 1980s that found that women who maintained a more normal appearance during chemotherapy had a better response to their treatment, less depression and a more positive outlook overall, on their treatment and their future. So it is important in four, yes, it is important to take care of yourself. And remember this is a temporary part of of life. with with with cancer, it's a certainly a crummy time. And there's a lot of things that can be unpredictable and bothersome. But there's a way to get through it. And part of that just comes from from from your outlook. There's lots of little tricks

Unknown Speaker  12:56  
for women who, for example, lose their eyebrows and eyelashes during during chemotherapy. There's really cool makeup tricks they actually make brow stencils that you can use to color in your eyebrows if you're not good with. With hand drawing, there's an opportunity to because you you're going to need to continually moisturize your your lips because of dry skin. You can moisturize with lip gloss and pick really cool colors. It's all the little things that you just kind of need to remember to do to

Unknown Speaker  13:29  
just to help keep you keep yourself looking good. I use specifically asked about cosmetic treatments. Yeah, so

Unknown Speaker  13:37  
if somebody is going through chemotherapy, and they wanted to do for example, Botox. It's not the Botox, that's an issue. It's that you're putting a needle through someone who is perhaps immunocompromised. So I am fine with doing treatment as long as the patient's oncologist is on board. I do have some patients who are stage four

Unknown Speaker  14:04  
cancer survivors who are on maintenance chemotherapy, and I usually just give a call to their oncologist and ask if they need to have bloodwork done before they have injections.

Unknown Speaker  14:18  
With filler or Botox, and you know not every type of chemotherapy

Unknown Speaker  14:24  
is necessarily going to immunosuppressed. So right. I think that you shouldn't discount that those things can be a possibility. And if that's something that is going to you know, help you stay feeling like you have a connection to your normal life, I think that's a good thing. Oh, that's great. Now, I just learned something because I would not have thought that so great. How are there some references that you might recommend for your lady? I have two two great books one is called beauty pearls for chemo girls. I love that and

Unknown Speaker  15:00  
It has a bunch of good tricks and tips about taking care of your skin, your hair, diet, exercise your whole overall outlook. It is part of the look good feel better organization, American Cancer Society. Yeah, yes. It was kind of born out of there. And there's interviews with makeup artists and medical professionals and women who've survived breast cancer. The other great book was actually written by one of my patients, and it's called surviving beautifully. And this book takes a little bit of a deeper dive into some of the questions about aesthetics during chemotherapy and radiation and cancer treatment and is very specific about different types of injectables. Can you have appeal Can you not have appeal? Can you have a laser eye and both books are very easy to read and have full pictures and references to websites. They both also have their own websites so surviving beautifully calm. And BP letter number four cg.com Oh, that sounds great. Okay, well, how about one last pearl or recommendation for you know anything, save spots on your face or discoloration? Go okay.

Unknown Speaker  16:28  
We have a bunch of really great skincare treatments at at the office for things like post chemotherapy hyperpigmentation that can be done once chemotherapy is completed. And you know, if somebody has has gone through and has a change of their skin type or and needs assistance and trying to figure out a new regimen or or treatment, they should feel free to consult with their friendly neighborhood plastic surgeon. I also have an aesthetician in my office, we offer complimentary skincare consultations for someone to come in and just talk about what products might be best for them. Oh, that's fantastic. Where can the listeners find you if they wanted to? Because you do Virtual Console. It's also yes and my esthetician also does virtual consults. You can find both of us@www.de Luca patel.com. It's d e l ewca. p yt. Like the Michael Jackson song, e Ll calm and Our phone number is 248-885-8858. I'm on Instagram as Dr. DeLuca Patel and Facebook and Twitter also as Dr. DeLuca pytel. Yeah, I follow you on Instagram. It's awesome.

Unknown Speaker  17:47  
I don't post anything

Unknown Speaker  17:49  
you do and it's awesome.

Unknown Speaker  17:53  
So, so I would say if if somebody were just tuning in at the very end here, I love your acronym, the cpms cleanse, protect, moisturize, soothe as a general idea if you're standing, you know, I don't know in the aisle at CVS I guess and you need to get something those are good cleanse, protect, moisturize, soothe. in general. No dyes, no additives, colors, fragrances, detergents, right? gentle skin stuff that is absolutely correct. Some of the things that are easy and forgettable are when you are washing to take short showers in lukewarm water avoid soaking in a bathtub where you're literally just stripping off all of your own natural moisture. You should moisturize while your skin is damp. And you should do an extra skin rinse and pat with a clean, dry cloth or use disposable cloths. That's great. Well, my friend. Thank you so much, Dr. Danielle DeLuca Patel for joining us on the breast of everything podcast. She is my girlfriend, the plastic surgeon, but you need her to be your girlfriend as well because she is awesome. So thank you so much for coming on with us, Lindsay and it's been an absolute pleasure to be on your podcast.

Unknown Speaker  19:16  
We have a good time in surgery if you couldn't tell everybody wants to be in our room. And so thank you so much to all of our listeners. Again. I am Dr. Lindsay gold of comprehensive breast care. We always want to hear from you. If you have a topic that you'd like us to talk about. We welcome your suggestions you can send them to comp breast care. com. That's compbreastcae.com

Unknown Speaker  19:47  
you've been listening to the breast of everything podcast with your host and board certified breast surgeon Dr. Lindsay gold of comprehensive breast care. If you have a subject you would like the surgeons to discuss, please email your surgeon

Unknown Speaker  20:00  
questions online at comp breast care. com. That's co mp breastcare.com. The doctors want to hear from you. The views thoughts and opinions shared in this podcast are intended for general education and informational purposes only, and should not be substituted for medical advice, treatment or care from your physician or health care provider. Always consult your health care provider first.

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